Nordhausen Katharina, Deutschbein Timo, Heinrichs Volker, Weyhe Dirk, Tabriz Navid
University Hospital for Visceral Surgery, Pius-Hospital Oldenburg, Carl Von Ossietzky University Oldenburg, Georgstr. 12, Oldenburg 26121, Germany.
Medicover Oldenburg MVZ, Elisenstraße 12, Oldenburg 26122, Germany.
Case Rep Endocrinol. 2024 Oct 17;2024:2393186. doi: 10.1155/2024/2393186. eCollection 2024.
The co-occurrence of medullary thyroid carcinoma (MTC) and papillary thyroid carcinoma (PTC) is thought to be a rare phenomenon. Here, we present a patient undergoing surgery due to a suspected MTC. Histopathological workup confirmed the suspected diagnosis but also described an incidental PTC in the contralateral lobe with lymph node metastasis in the central cervical compartment. A 58-year-old female presented with thyroid nodules and significantly elevated levels of calcitonin and carcinoembryonic antigen (CEA). She underwent total thyroidectomy along with central and bilateral lymph node dissection. Histology revealed a MTC of 20 mm and a BRAF V600E-positive PTC of 11 mm with central cervical lymph node metastasis. Postoperatively, ablative radioiodine therapy was performed. Two months later, both calcitonin and CEA were normalized. Simultaneous occurrence of MTC and PTC seems to be rare, but recent literature suggests that simultaneous occurrence is probably more frequent than initially thought. Preoperative calcitonin can be helpful in the diagnostic workup of thyroid nodules. Due to different treatment strategies, precise histological differentiation of potential lymph node metastasis is essential.
甲状腺髓样癌（MTC）和甲状腺乳头状癌（PTC）同时发生被认为是一种罕见现象。在此，我们报告一名因疑似MTC接受手术的患者。组织病理学检查证实了疑似诊断，但同时也发现对侧叶存在偶然的PTC，并伴有中央颈部区域的淋巴结转移。一名58岁女性因甲状腺结节以及降钙素和癌胚抗原（CEA）水平显著升高就诊。她接受了全甲状腺切除术以及中央和双侧淋巴结清扫术。组织学检查显示一个20毫米的MTC和一个11毫米的BRAF V600E阳性PTC，并伴有中央颈部淋巴结转移。术后进行了放射性碘消融治疗。两个月后，降钙素和CEA均恢复正常。MTC和PTC同时发生似乎很罕见，但最近的文献表明，同时发生的情况可能比最初认为的更为常见。术前降钙素有助于甲状腺结节的诊断检查。由于治疗策略不同，对潜在淋巴结转移进行精确的组织学鉴别至关重要。
